Qualitative Research in Counseling: A Reflection for Novice Counselor Researchers

Counselors practice in a wide range of disciplines, but also represent a distinct discipline separate from medicine, psychology, and social work. Particularly in countries like Australia, Canada, and the Asia Pacific nations, as a relatively new field, counseling is taking up the challenges of encouraging a research culture that can both critique and support clinical practice and counselor education. This paper is thus written to support novice counselor researchers, and to inspire an emerging research culture through sharing formative experiences and lessons learned during a qualitative research project exploring minority issues in counseling

Sagas, Suicides and Sequels: Narratives of the Family Experience of Suicide

Suicide and the events that lead an individual to end their life have been extensively researched over the last three decades. Earlier research studies have reported on the societal, ecological and psychological factors relating to suicide. However, the role of family relationships in the lives of suicide attempters or completers has not been as widely researched. This qualitative study examines the experiences of eighteen family members who shared their experience of losing an immediate relative through suicide. Narrative inquiry was used to analyse the interview data. The analysis identified relationships as pivotal in the grief meaning construction following the death by suicide of their family member. These aspects of family functioning colour the interpretations and meaning construction that the bereaved family members formulate in their grief narrative

Sexual Harassment and Australian Registered Nurses

Using a multi-method approach, this thesis examines sex-based and sexual harassment as perceived and experienced by Australian Registered Nurses (RN). The first phase of the research was a broadly based, exploratory survey questionnaire which served as a foundation for the second and third phases of the study. This initial phase and its analysis focused on the frequency and kinds of harassment the Registered Nurses described, as well as their responses and the affects of the harassment on them personally and professionally. ... The second phase of the study involved sixteen in-depth interviews that focused on how Registered Nurses acquire or process knowledge about harassment and how this knowledge is personally and socially reproduced. That is to say, how these RNs come to 'see' and 'understand' harassment; come to recognise harassment, label it, deal with it and interpret their action or inaction when confronted with it

Managing Sexually Transmissible Infections in Clinical Practice: Evidence from New South Wales, Australia

Sexually transmissible infections (STIs) are on the increase in Australia. The considerable health, psychosocial, and economic consequences of STIs underscores the need for their better prevention and control. As primary health care providers, general practitioners (GPs) with their incomparable access to the Australian population are best placed to provide effective sexual health services. However, earlier research suggests that there are inconsistencies in the provision of clinical care for STIs in general practice in Australia, although little is known about STI care by GPs in the state of New South Wales (NSW). The purpose of this study is to develop an understanding of how STIs are managed in general practice, and to examine how STI care in general practice differs to that in specialised practice staffed by sexual health physicians (SHPs)

An Australian whistleblowing experience in healthcare: A study of six women from the New South Wales public health system who were labelled by the media as whistleblower nurses

In the Australian state of New South Wales (NSW), six women with 200 years clinical experience between them were employed by different hospitals within a common Area Health Service. Independently, and unknown to each other, they advocated for patients' rights and patient safety through hospital internal escalation channels. After failing to garner satisfactory responses, these nurses were deliberately drawn together by another colleague, who without their consent or knowledge escalated their individual concerns to the media: where they were portrayed as a vigilante group of whistleblower nurses. This research explores the premise the inherent moral and ethical qualities and responsibilities of a nurse demand nurses advocate for patients. As a facet of care, this action differs fundamentally from other experiences of whistleblowing. Three rounds of in-depth interviews were audio-taped, transcribed and analysed, to provide data to address the issues associated with nurses who are labelled as whistleblowers. The study group was identified to the researcher by another nurse, who attempted to aggregate this group of nurses to release information about their patient safety and advocacy issues; to add credibility to her own concerns about patient care; and to promote through the media an image of a cohesive group of vigilante whistleblower nurses. Telling the stories and identifying the consequences of each nurse's experiences provides the key findings of this research. The set of harms identified spans not only the whistleblowing events, but also the conduct of this research, whose author is a participant observer. The major research implications and recommendations relate specifically to the role of the media in whistleblowing, the concept of advocacy and the impact of Australian law upon nurses who speak out publicly. The recommendations challenge the appropriateness of labelling nurses as whistleblowers. The survival strategies of whistleblower nurses are explored and recommendations are made to address 'mobbing' - a severe form of bullying and harassment. The concept of risk to a researcher who undertakes sensitive research is explored, and recommendations for researcher protection are defined. The nurses have survived, albeit altered personally and professionally. This is the story

Understanding the Role of Thai Community Hospital Directors in Implementing the Universal Health Coverage Policy in Relation to Primary Health Care

In 2001, Thailand adopted the Universal Health Coverage (UHC) policy. This policy focuses on Primary Health Care (PHC), with the aim of reforming the Thai health system to provide health services to all, regardless of a person's ability to pay. The Community Hospital Director (CHD), as the middle manager of the provincial health system and the leader of the district health system of Thailand, is a catalyst for communication up and down the organisational structure, and between executives and front-line services implementing this policy for the rural poor. The role of the CHD is influenced by structural interests, professional sub-cultures, the organisational context and the relationship between the Community Hospital and the communities. For Thai health reform the greatest hope for improving efficiency lies with changes in the provision of primary health services at the community level and this entails understanding the role of the CHD. This study presents a qualitative study of eight CHDs and 35 stakeholders involved in the implementation of rural health care reform (the UHC policy and PHC) in order to understand the structural and institutional factors affecting the Thai CHDs in implementing the UHC policy in relation to PHC, and the complex real life context for primary health care delivery and implementation in rural Thailand. The research design is mixed methods with in-depth interviewing preceeding and informing a focus group. The data analysis technique used in this study is thematic analysis. The results show that the sustainability of PHC services provision under the administration of community hospitals to meet the needs of rural poor may be problematic. Many barriers at the policy and operational levels limit the role of the CHD, who is the lynchpin of the Ministry of Public Health at district level. These barriers include structural interests, understanding of PHC as Primary Medical Care (PMC), Thai bureaucratic management style, and the difference in professional sub-cultures. Moreover, there is no structural and operational support for the CHD's management role. These factors concentrate the consequences of the dual role of the CHD as clinician and manager. These consequences also seem to be linked to the CHDs' primary training in biomedical science. In response to the barriers, the CHDs act according to a 'medical mindset', focusing on their interests, professional autonomy and their hospitals, rather than on the broader health needs of the community. The goal of the UHC policy in providing equity of access to PHC to all citizens may not be achieved, unless the role of CHDs, as both 'professional manager' and 'community developer', is encouraged through training in health management and PHC and is supported by the government. The concept of comprehensive PHC should be acknowledged and put into practice by all stakeholders, both within and outside the health sector. In addition, the government needs to clarify the roles and responsibilities of all stakeholders in district health services management

Parental Portraits of Suicide: Narrating the Loss of a Young Adult Child

Elevated rates of suicide among young people throughout the Western world have been of concern, particularly during the past three decades. Australia was one of the first countries to respond with a national initiative to address this devastating trend. Still many lives are lost, and for those left behind, devastating grief at the loss of young life. To date, little research has been undertaken in this area, and as a consequence this grief tends to be poorly understood. This study provides empirical data, which examines the experience of parents bereaved through their son or daughter's suicide death. In-depth interviews with 22 mothers and fathers elicited their narratives surrounding the experience of suicide. Interview data was analysed using a narrative method, which examined both the smaller narratives within each story and the plotlines that permeate the stories of the group as a whole. This analysis revealed three narrative components that parents use to talk about and give meaning to their experience. The first speaks to tea manner in which parents find themselves silenced after the suicide death of their child. The second accounts for how prepared or otherwise parents are for the suicide death of the child. The third explores death as a physical end to life, but elaborates on a parent's enduring relationship with their child. The findings of this study highlight the need for a social health framework to understand suicide-bereaved parents' experiences, as it takes place within a particular social and cultural realm. This framework recognises that in some instances the suicide may be anticipated, and the bond that a parent shares with their child in life continues after death. Most importantly, these findings recognise that these young people are much more to their parents than their suicide death. In light of these findings, recommendations for suicide prevention and postvention services are made along with identification of unanswered questions that will require future investigation

Body Mapping: Self-reflective Views of Student Musicians

This study examines student musicians' perceptions of their performance and development as a result of using Body Mapping (BMG) technique. BMG is a somatic (mind-body) education technique designed to teach musicians skills in self-evaluation and change for performing with sensory-motor integrity. A qualitative research design guided by an interpretive framework was used to collect data from undergraduate students and their studio teachers at an American university. Data involved in-depth interviews, self-reflective journals, and course materials. A typology for how participants were able to master BMG in performance is used to describe their experiences and learning outcomes. The main findings show BMG positively impacted the majority of students in the study. The data reveals enhanced ability for musical expression (e.g. dynamics, phrasing, conveying emotional information), the ability to focus more easily on elements contributing to expressive outcomes, and greater personal confidence to be musically expressive. The study also shows improvements in technical development and performance skills including a perception of a clearer understanding of breathing, better physical coordination and flexibility, enhanced arm movement, improved articulation, feeling centered or grounded, the ability to retain focus under pressure, and the freedom to make artistic choices during musical performance. BMG enhanced students' development of self-awareness which was demonstrated by their ability to find solutions to technical challenges, understand how tension inhibits movement, increase their awareness of movement pattern consequences on pain symptoms, and gain more accurate perceptions of movements. Some participants reported an absence of playing-related pain at the end of the study. All shared a belief in the value of BMG derived from positive personal experiences and observation of improvements in others. Many students displayed characteristics of successful self-regulated learners. Determinants of student success include a positive attitude, consistency of work, realistic expectations, ability to transform problems, willingness to commit sufficient time to the process of change, and positive studio teacher support. BMG also shows promise for inclusion in a therapeutic team-approach for treatment of playing-related pain/injuries. In sum, the study confirms the efficacy of BMG instruction for enhanced technical and performance outcomes in musical settings. Study outcomes are relevant for musicians, educators, and health practitioners in the field of music medicine

Promoting Academic Staff Capacity in Vietnamese Higher Education: Towards an Effective and Sustainable Development Model

In Vietnam, education is an important part of society, a major preoccupation of government and a concern for every family. Yet, the quality of education, across every level, especially in Higher Education remains problematic. Among various officially recognized reasons for this are the quantity and quality of academic staff. In an economy in transition, including a rapidly expanding Higher Education system, the Government believes that major reform in academic staff development is necessary. However, academic staff development is at an early stage of emergence and it requires considerable additional emphasis and effort. A part of this study seeks to assess the development needs of Vietnam's academics. To accomplish this survey, methodology was employed including questionnaires being distributed to 240 academic staff and 200 Rectors and Vice-Rectors. It is the first time that surveys with this number of academic staff and Rectors and Vice-Rectors have been completed concerning academic staff development in Vietnamese Higher Education institutions

Migrant Populations: Socio-cultural Dynamics and the Explanation for the Risk of HIV/AIDS Transmission in Bangladesh

Several studies reported premarital and extra-marital sex in Bangladesh society, including among migrant workers. Some studies documented extra-marital sex among the wives of the migrant workers, confirmed prevalence of HIV among migrant workers' families and transmission of HIV from migrant workers to their wives and children. However, most of these studies concentrated on risky behaviors and knowledge about HIV/AIDS. The social and cultural factors that may shape the risk behaviours of migrant workers and their wives while they live away from each other have largely been ignored. Against this backdrop, the present research aimed to understand and explain the factors associated with risky sexual behaviours of the wives of the migrants and non-migrant workers and their vulnerability to HIV infection. The research particularly focused on the socio-economic factors, and the religious-cultural context that could influence the risk behaviours of migrant and non-migrant men and wives of the migrant men in a rural area in Bangladesh. The present research consists of two components: (i) a descriptive, quantitative part that analyses a secondary data set on the wives of migrants and non-migrant workers, and (ii) an exploratory, qualitative component that probes the socio-cultural issues from in-depth interviews with migrant and non-migrant men and wives of the migrant and non-migrant men